Access to health services is about more than just health insurance.  Understanding the public health care system and having a primary care provider are key components of the access to health services story.  Access to comprehensive, quality health care services is important for promoting and maintaining health, preventing and managing disease, reducing unnecessary disability and premature death, and achieving health equity.¹

2018-2023

Policies and Legislation

• The New Jersey Health Insurance Market Preservation Act (P.L.2018, c.31) requires most state residents to maintain health coverage.
• The Palliative Care Act (P.L.2019, c.227) requires certain health care facilities to provide information concerning palliative care and hospice care services.
• Cover All Kids (P.L.2021, c.132) is a state initiative that aims to provide health insurance coverage to all children in New Jersey, regardless of their immigration status or family income. The initiative began in 2023 and it has already made a significant impact on access to care for New Jersey children by
  • Eliminating premiums and waiting periods.  
  • Expanding Medicaid eligibility to 16,000 children who were not previously eligible. 
  • Providing outreach and enrollment assistance in multiple languages to help to understand their options and enroll their children in the right plan. 
• The New Jersey Supplemental Prenatal and Contraceptive Program (NJSPCP) is a state-funded program that provides free or low-cost prenatal and contraceptive care to uninsured and underinsured women in New Jersey. 
  • The program was expanded in 2017 to include coverage for primary care services, such as well-child exams, sick visits, and preventive care. It was expanded again in 2018 to ensure undocumented women could access services.  The expansion of NJSPCP is a significant step forward in improving access to health care for undocumented women in New Jersey. 
  • As of March 2023, over 10,000 women have enrolled in NJSPCP through the expansion. 

Outreach by NJDOH’s Office of Primary Care and Rural Health

• Helps to coordinate enrollment in Cover All Kids.
• Works with Horizon Blue Cross Blue Shield and 211 to coordinate and expand access to Medicaid enrollment events for adults and children.
• Works with Federally Qualified Health Centers (FQHCs) and community partners in select cities -- Trenton and Camden -- to increase access to immunization for children and link uninsured children to respective FQHCs.

Grants given by NJDOH

• Each year through the Uncompensated Care Fund, up to $32 million is allocated to the FQHCs for the provision of primary, dental, and mental health services. During FY2022, reimbursements through Uncompensated Care Fund enabled over 260,000 individuals to receive these services.

Grants received by NJDOH

• Federal Office of Rural Health Policy (FORHP) in the Health Resources and Services Administration (HRSA)

Assets/resources

• Federally Qualified Health Centers make improving access to care for the underserved populations in New Jersey possible.
• The Rural Health Action Plan and Primary Care Needs Assessment were developed by the Office of Primary Care and Rural Health to identify access to care issues and recommend solutions to these issues.

Challenges

• There is a lack of administrative resources to track the impact of the Uncompensated Care Fund adequately and efficiently.

Disparities/inequities

• The Uncompensated Care Fund is designed to address inequitable access to care for uninsured and underinsured populations. Although health care expenditures increase annually, and patient needs increase and change regularly, the FQHCs have continued to provide consistent care to their patients.
• The uninsured rate among Hispanic persons under age 65 years is more than double that of other racial/ethnic groups.
• About two-thirds of Hispanic adults have a primary care provider compared to more than 83% for other racial/ethnic groups.

Final Assessment

• One of three Access to Health Services targets was achieved by 2020.
  • The target was achieved for health insurance coverage among persons under age 19 years.
• Health insurance coverage for all persons under age 65 years improved but the target was not met.
• The proportion of adults with a primary care provider declined over the decade.

For more information, please refer to these resources:

• NJ FamilyCare
• Get Covered NJ (New Jersey's Official Health Insurance Marketplace)
• healthcare.gov (Affordable Care Act enrollment)
• Healthy People 2030

Reference:

1. Access to Health Services. Healthy People 2020. 10/8/20.

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